Brain and Mind Institute, Western University, London, Canada; Brain Development Imaging Lab, San Diego State University, San Diego, USA.
Brain and Mind Institute, Western University, London, Canada.
Neuroimage Clin. 2018 Feb 3;18:399-406. doi: 10.1016/j.nicl.2018.02.002. eCollection 2018.
Functional connectivity magnetic resonance imaging (fcMRI) of neonates with perinatal brain injury could improve prediction of motor impairment before symptoms manifest, and establish how early brain organization relates to subsequent development. This cohort study is the first to describe and quantitatively assess functional brain networks and their relation to later motor skills in neonates with a diverse range of perinatal brain injuries.
Infants ( = 65, included in final analyses: = 53) were recruited from the neonatal intensive care unit (NICU) and were stratified based on their age at birth (premature vs. term), and on whether neuropathology was diagnosed from structural MRI. Functional brain networks and a measure of disruption to functional connectivity were obtained from 14 min of fcMRI acquired during natural sleep at term-equivalent age.
Disruption to connectivity of the somatomotor and frontoparietal executive networks predicted motor impairment at 4 and 8 months. This disruption in functional connectivity was not found to be driven by differences between clinical groups, or by any of the specific measures we captured to describe the clinical course.
fcMRI was predictive over and above other clinical measures available at discharge from the NICU, including structural MRI. Motor learning was affected by disruption to somatomotor networks, but also frontoparietal executive networks, which supports the functional importance of these networks in early development. Disruption to these two networks might be best addressed by distinct intervention strategies.
对围产期脑损伤的新生儿进行功能连接磁共振成像（fcMRI），可以在症状出现前改善运动障碍的预测，并确定早期大脑组织如何与后续发育相关。这项队列研究首次描述并定量评估了功能脑网络及其与新生儿多种围产期脑损伤后运动技能的关系。
从新生儿重症监护病房（NICU）招募婴儿（=65，最终分析中包括：=53），并根据出生时的年龄（早产儿与足月儿）以及结构磁共振成像是否诊断出神经病理学进行分层。在足月时的等效年龄，通过自然睡眠获取 14 分钟的 fcMRI，以获取功能脑网络和功能连接中断的度量。
躯体运动和额顶叶执行网络连接的中断预测了 4 个月和 8 个月时的运动障碍。这种功能连接的中断并不是由临床组之间的差异或我们为描述临床过程而捕获的任何特定指标驱动的。
fcMRI 可预测新生儿重症监护病房出院时其他可用的临床指标，包括结构磁共振成像。运动学习受到躯体运动网络中断的影响，但也受到额顶叶执行网络的影响，这支持了这些网络在早期发育中的重要功能。这些两个网络的中断可能需要通过不同的干预策略来解决。
